Hyperbaric oxygen therapy for male infertility: a systematic review and meta-analysis on improving sperm quality and fertility outcomes

Abstract

Hyperbaric oxygen therapy has emerged as a potential adjunctive treatment for male infertility, as it targets various sperm abnormalities and improves fertility outcomes. This systematic review and meta-analysis synthesized data from randomized controlled trials to evaluate the efficacy of hyperbaric oxygen therapy in treating male infertility. A comprehensive literature search identified nine eligible studies, which were assessed for quality using the Jadad scale and analyzed for heterogeneity. The meta-analysis revealed significant improvements in sperm survival, density, morphology, normal sperm rates, and motility following hyperbaric oxygen therapy, with an increased clinical pregnancy rate. Subgroup analyses based on infertility etiology and treatment duration further elucidated the heterogeneity of male infertility stemming from the etiology of infertility. Despite the high robustness of the meta-analysis results, the study is limited by the small number of included trials and potential publication bias. In conclusion, when combined with conventional treatments, hyperbaric oxygen therapy significantly enhances sperm parameters and fertility, underscoring its role as an effective adjunctive therapy for male infertility.

Keywords: asthenospermia; chronic bacterial prostatitis; hyperbaric oxygen; idiopathic male infertility; male infertility; meta-analysis; oligospermia; sperm; teratospermia; varicocele.

Figure 1

Flowchart of the literature selection process for hyperbaric oxygen therapy in the treatment of male infertility. The literature search was conducted across multiple databases, including Cochrane, PubMed, Web of Science, CNKI, VIP, and WanFang Data. Additionally, other sources, such as nondatabase publications released by the media, were also considered.

Figure 2

Forest plot of the meta-analysis of hyperbaric oxygen therapy for the treatment of male infertility. (A) Sperm viability; (B) sperm density; (C) sperm abnormality rate; (D) normal sperm rate; (E) sperm motility; (F) clinical cure rate (pregnancy rate). The effect size is represented as the log risk ratio.